Ok I think I got it. So the other numbers don't mean much, just the first number? In this instance it was 2. The doctor did note it was palpated approximately 1.5cm.The lesion size, per CPT, is based on the 'greatest clinical diameter' plus margins, so for these measurements you would use 2 as that is the largest of the measurements - you would not add the different measurements together. Ideally the physician should document this as the lesion size may have changed by the time it reaches pathology, or the lesion may have been broken into smaller pieces during excision, but if this is all you have, that's what I would use.
Yes, you take the largest number only (not necessarily the first).Ok I think I got it. So the other numbers don't mean much, just the first number? In this instance it was 2. The doctor did note it was palpated approximately 1.5cm.